Romanian Family Doctors Allotted More Money For Services, Less For Patients - Draft

At the moment, national funds for primary healthcare are divided between "per capita" (70%) and "per service" (30%). According to the new draft contract, the split will be changed to 60% "per capita" and 40% "per service." The National Health Insurance House says this will improve the efficiency of healthcare provided to a family doctor's registered patients, while making a practice's activity more dynamic.

The draft also says medical service, medicine and equipment supply contracts may be suspended for the supplier's non-payment of contributions to the social health insurance fund. A contract will be suspended 30 days after the health insurance house's latest transfer to a supplier.

The new frame-contract says doctors will be allotted a certain budget for prescription drugs and the conditions of co-payment have also been established. Health insurance houses are required to recover the value of the services from suppliers, if they were provided illegally. Suppliers of paraclinical services will have to be able to provide at least half of the medical tests included in the base paraclinical service package. Every laboratory will need to staff a specialist doctor or biologist or bio-chemist.

Stays in hospital will be discounted up to a maximum fee per day, according to the new contract. This applies to chronic illness and recuperation hospitals, as well as chronic illness, recuperation, neonatology departments of other hospitals.

The new act also introduces the concept of "family pharmacy," meaning people insured through the social healthcare system may opt for a pharmacy to cover their prescription. The contract also states doctors will be required to prescribe medicine by using its International Nonproprietary Name (INN), apart from justified cases when the doctor may use a commercial brand. With the exception of commercial brands recommended by the doctor, a pharmacist's suggestions of commercial products matching an INN shall go from the lowest-priced to the most expensive.

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